Endoscopy is a minimally invasive diagnostic medical procedure used to view interior parts of the body, such as the interior or exterior surfaces of organs, joints or cavities. It enables physicians to peer through the body's passageways. An endoscope typically uses two fibre optic lines. The first, a “light fibre”, carries light to the region of the body to be viewed. The second, an “image fibre”, carries the image of the region back to the physician's viewing lens or, where desired, to a camera so that the image may be displayed on a screen.
There are also other endoscopes that rely on camera technology at the end of the scope, and are sometimes referred to as are videoendoscopes. These have small digital cameras rather than optical fibre bundles. The video bronchoscope has a built in camera which is transmitted to a viewing screen.
The portion of the endoscope inserted into the body may be sheathed in a rigid or flexible tube, depending upon the medical procedure. One or more lenses may be provided at the end of the endoscope to enhance image capture and/or illumination of the body region. Ports may be provided to for administering drugs, suction, irrigation, and introducing small instruments.
For applications such as bronchoscopy, the tube must be sufficiently flexible to allow it to be accommodated in body passageways without undue discomfort or injury to patients under examination, but must be rigid enough to cause it to move through passageways without bunching up. Physicians operate an endoscope by controlling how far the tube is inserted in the body cavity, the rotation of the tube and also the bending of the tube along its length.
The tips of endoscopes may be selectively bendable in at least one direction so that the tip may be pointed in a desired direction. Through control of the bend of the tip and rotation of the endoscope tube, the tip of the endoscope may pass through bends in the interior passageways without the tip directly impinging on the walls. This also facilitates the desired path to be selected at a junction, e.g. where the trachea meets the left and right bronchi.
A physician may practice procedures on a patient but this is not desired, at least during early stages of training as inexperienced operators may injure a patient or damage the equipment (endoscopes are fragile, complex and expensive to replace).
Physical models of passageways or “airway mannequins” may be used in place of patients but these suffer from difficulty in accurately mimicking the contour and surface characteristics of the passageways. It is generally necessary to use genuine endoscopes with mannequins and so they do not prevent the endoscopes being damaged and the associated cost. Also, they remove endoscopes from clinical use and raise sterility concerns. The mannequins themselves are expensive and limited in that each mannequin is modelled on a particular type of patient (e.g. paediatric versus adult). Thus, it is necessary to obtain a variety of mannequins or for physicians to practice in an environment which differs from that of a patient to be operated on. To overcome these problems, simulators have been created which avoid the use of an actual endoscope. For example simulators of varying types are shown in GB-A-2,252,656, WO-A-96/30885, WO 2009/008750 and the simulation software High Techsplantations' Telios. The physically based simulators generally rely on use of an endoscope, or a close facsimile thereof, which is slid into an aperture in a simulation box. Within the box are sensors to detect rotation and movement of the endoscope. These then feed the sensor outputs via a cable or wireless connection to a computer. The computer then translates these sensor outputs into movements on screen which the operator can then use to control the endoscope and practice.
Physical models of passageways or “airway mannequins” may be used in place of patients but these suffer from difficulty in accurately mimicking the contour and surface characteristics of the passageways. It is generally necessary to use genuine endoscopes with mannequins and so they do not prevent the endoscopes being damaged and the associated cost. Also, they remove endoscopes from clinical use and raise sterility concerns. The mannequins themselves are expensive and limited in that each mannequin is modelled on a particular type of patient (e.g. paediatric versus adult). Thus, it is necessary to obtain a variety of mannequins or for physicians to practice in an environment which differs from that of a patient to be operated on.
To overcome these problems, simulators have been created which avoid the use of an actual endoscope. For example simulators of varying types are shown in GB-A-2,252,656, WO-A-96/30885, WO 2009/008750 and the simulation software High Techsplantations' Telios. The physically based simulators generally rely on use of an endoscope, or a close facsimile thereof, which is slid into an aperture in a simulation box. Within the box are sensors to detect rotation and movement of the endoscope. These then feed the sensor outputs via a cable or wireless connection to a computer. The computer then translates these sensor outputs into movements on screen which the operator can then use to control the endoscope and practice.
In this specification where reference has been made to patent specifications, other external documents, or other sources of information, this is generally for the purpose of providing a context for discussing the features of the invention. Unless specifically stated otherwise, reference to such external documents is not to be construed as an admission that such documents, or such sources of information, in any jurisdiction, are prior art, or form part of the common general knowledge in the art.